Throat Clearing, hoarseness, swallowing difficulties

I had inflamed sinuses and "eustachian tube dysfunction"  or "ETD" as well.  ETD is when the eustachian tubes don't open and close very easily, and it feels like your ear is clogged all the time, and you have to deliberately pop your ears to equalize the pressure.  Normal eustachian tubes automatically pop on their own as you swallow, or talk, or chew food.  But with ETD, this doesn't happen.  

The eustachian tubes open right behind the nose, in the back of the throat.  Throat pain can sometimes feel like ear pain, for that reason.  The nerves run from the throat to the ear.  

I have a few posts over on the Eustachian Tube Dysfunction board on this site, because that is my last lingering problem, but it's a lot better now than it was.  At one point, I couldn't even pop my ears deliberately, because the inflammation was so bad.  

Here are a few things I know can give you ETD:

1) Vitamin A deficiency - Vitamin A is required for all the epithelial layers in the body, like the sinus, the surfaces of the eyes and inner eyelids, the inside of the mouth, cheeks, throat, and ears.  Vitamin A is needed for "goblet cell" function, and mucus secretion.  If you are low in vitamin A, your globlet cells die off, or lose their function, and mucus may become thicker or dry up completely.  You can lose the ability to lubricate all of these areas.  Eyes can feel dry, eustachian tubes "click" when you swallow" because they are dry, the mouth can feel dry even when there is saliva.  It's because these surface tissues change, and lose their function.  The eustachian tubes are probably the first place this is felt.   The epithial surface in the ear canal naturally loses oxygen through difussion, but in vitamin A deficiency, the tissus lose air a lot faster, changing the pressure inside of the ear faster, even though you aren't changing altitude.  And you feel like your ears need to be popped all the time.  You can usually pop them easily, but you will feel clogged almost right away again.  Most people think of carrots for vitamin A, but carrots and other plant sources contain no vitamin A, only beta-carotene which the body must convert into vitamin A.  The best sources of actual vitamin A are egg yolks and liver.  Or you could just take a supplement.

2) Iodine deficiency - the first place you generally feel this is in your salivary glands.  You will feel like you just can't make very much saliva.  There are actually several different salivary glands.  The parotid gland is a salivary gland over your jaw, next to your ear.  The gland can become enlarged or swollen during iodine deficiency, and then it presses on the components of the ear.  It can even feel like it's your jaw aching, or your ear aching.  Your mouth doesn't only feel dry, it literally is dry - very little saliva.  So this in turn leads to a dry throat that can become inflammed.  

3) B-vitamin and iron deficiency - you will also have symptoms of this on the tongue, usually a red tip, and red sides of the tongue.  The tongue may be sore, swollen, with imprints of the teeth in the sides of the tongue.   The lining of the throat becomes red and inflammed, and since the eustachian tubes open into the throat, the inflammation makes it harder for the tubes to open, causing that clogged ear feeling.  Popping the ears becomes more difficult.  B12 and folate are the two most common b-vitamin deficiencies.  B12 deficiency can cause dizziness and headaches, and facial muscle twitches, and even pain in the face that feels like sinus pain.

At one point, I had ALL of the above.  My ears wouldn't pop, and hurt so bad I couldn't sleep and put hot packs on my jaws.  Along with a dry throat, and constant drip, lost voice.  My ENT scoped me at the peak of having all of these things going on and said he thought I had a cold along with reflux.  I saw four different doctors.  Never did any of my doctors suggest vitamin deficiencies, when in fact, that's what all my sysmptoms were.

The thing is, it's much safer to try some vitamins for a week (and you'll know very quickly if it helps), than to try PPI's or acid reducers, which will make you more deficient.   And which they want you to be on for six weeks before you'll know if it's helping.  

That's why the alginate, or alginic acid, is a safe way to go.  It's just a physical block to keep the stomach contents where they belong.  And it won't cause you other problems.  I'd stop the other stuff since it's not helping, and try the vitamins, one at a time, starting with vitamin A in retinyl palmitate form.  You'll know in a few days if it helps.    

What kind of b-vitamins are you taking?  The form really does make a difference.  Taking a B12 in methylcobalmin form is probably the most important.  B12 deficiency is the silent epidemic.   It is not found at all in plants, and only in small amounts in meats except for liver.  It's fortified in milk, but if you don't drink milk... it's just a good insurance policy to take a B12 supplement.

Hope this helps!

Amy

I might seem like I must have had the worst diet ever to become deficient in some vitamins.  But actually, I was a very healthy eater compared to the average person.  I never drank soda, or ate candy, or chips.  I ate a variety of foods, with plenty of fresh fruits and vegetables, meat, eggs and seafood.  I didn't drink alcohol more than a couple drinks a month.  I've always exercised regularly and I've always been a healthy weight.  I haven't taken antibiotics in more than ten years.  

It can happen to anyone. Our food supply has many contaminants and anti-nutrients, even organic food does.  And it contains less iodine than ever before.  Don't rule out deficiencies as a possibility for your health issues, as I did and needlessly suffered for way too long.  

- fatigue, weight gain, weakness, increased cold sensitivity, constipation, dry skin, and depressed mood. Your hair and nails may be thin and brittle. 

Besides the depression and weight gain ( I lost 50 pounds but is because I am eating alot less) I have all the other symptoms.  Even my har and nails. ;-(  I no longer eat lorized salt, dairy, 1 egg once every 2 weeks and no white or wheat bread. I guess I have to get back to eating some of these foods I took away when I had HBP and High Cholesterol which I no longer have.  I have been eating alot less than before and as you can see I took away everything that had fat, sugar and salt.  Not going back in full, but I have to not limit my food so much and start eating some of these foods at a lower amount.

There is a long list of symptoms for B12 deficiency:

Fatigue

Anxiety and depression

Heart palpitations

Irregular heart beat

Awareness of heart or feeling of heavy heart beats

Sore tongue or mouth

Tingling or numbness in the fingers and toes

Forgetfullness

and more...  

B12 is very hard for the body to absorb.  You need something called "Intrinsic Factor" to escort B12 to the small intestine.  And you need stomach acid to trigger the stomach to release Intrinsic Factor.  Low stomach acid means low B12 absorption.

You can get a blood test for B12, but the body works very hard to maintain adequate levels of B12 in the blood, and deficiencies only show up in blood tests when they are extreme.   B12 deficiency leads to anemia.  Anemia can cause swallowing difficulties, sore tongue, breathing problems, heart problems...  

Weekly or monthly shots of B12 are the usual solution, but require a doctor's visit for every shot.  You can take a supplement as well.  You need to make sure to take a large enough dose though.  Only a tiny fraction of a B12 supplement is absorbed, according to the research.  That's why B12 supplements are usually huge amounts like 1,000 or 5,000, even though you only need 1.2 a day.  It's because you only absorb a fraction of the supplement.  

I've been taking B12 for a few months, and I tried to stop but recently got some symptoms back.  

The liver stores 7 years of B12.  If you develop deficiency of B12, it will take a few years to build back up your stores.

For example, I went out for sushi and ate a seaweed salad, and the next day felt incredible.  I mean, I could SEE better the next day.  Things improved that I didn't even know were not working well in my body.  

Also, the reverse happened.  I had been avoiding alcohol because of the reflux.  But a very dear friend came to visit and I had way too much to drink.  The next day, my lips looked magenta and I wasn't wearing any lipstick.  And some of the same throat symptoms (which until then had gone away) returned with a vengence.  Alcohol sucks all the b-vitamins out of you.  And I was experiencing deficiency symptoms you'd normally only see in photos from developing countries.  

All of these experiences alerted me to the fact that somehow I'd developed a vitamin and mineral issue.  I started reading a lot of about vitamins.  There were some surprising connnections between vitamins and my mouth and throat symptoms.   And then I started experimenting cautiously to see what helped. 

Your mouth and tongue can tell you a lot about your vitamin status.  If you want to see a full list of vitamins and how deficiencies show in your mouth, just search on "tongue and deficiency" and you will get several decent lists.  There are blood tests for some deficiencies in things like B12 or folate, but these will only show positive when you are so deficient there may be permanent damage to nerves.  Iron is a good test to have done, but they need to check ferritin, not just iron.  I learned by trial and error which vitamins helped and which ones didn't.  

I think we sometimes get stuck on a single diagnosis for all our symptoms, when in fact it could be multiple different problems.   Doctors also can miss things because one diagnosis seems to cover all the symptoms.  I have seasonal allergies and have had testing done and it's been confirmed that I am very allergic to trees, grass, pollen, etc.  For ten years, I had horrible sinus pain, headaches, dry itchy eyes and post-nasal drip, and thought it was all from allergies.  I never considered that some of my symptoms could be anything other than allergies.  I accepted my situation because trying not to think about the pain was how I coped.  Well, that and 5 different medications and weekly allergy shots.  I didn't want to think about how i felt, I just wanted to live my life.    It was only when it got worse than I could have ever imagined, and I needed to wear an allergy mask to go outside, that I started looking for more answers and saw new doctors.  The reflux diagnosis was a wake-up call to me that my problems could be something besides allergies.  I don't know why I never considered I might have more than one problem - allergies AND something else.  It was just a logic problem in my head.  And also when you feel bad, you can't think very clearly.  

That's really my main message that I hope helps people on here.  You may have reflux AND something else too.  Many different things can cause these same symptoms.  Unfortunately, doctors are less familiar with nutrition and symptoms of deficiency, and are going to miss the signs.  

Anyone on reflux meds will end up with low stomach acid and that causes food to not be broken down properly.  You need acid in your stomach to digest food and extract nutrients from it.   I think any doctor prescribing acid lowering medication should be required to be knowledgeable about nutrient deficiencies and should be able to recognize them.

My dry itchy eyes and post-nasal drip were from riboflavin deficiency.   The lump in my throat and swallowing difficulty was from iron deficiency.  My headaches and "sinus" pain were from B12 deficiency.   I only know these things because of experimenting.  I read a lot.  I wish there was a better way, but I have seen six different doctors over the past year and none of them was able to help.